Angiogenesis in primary and metastatic epithelial ovarian carcinoma

OBJECTIVE: Our goal was to evaluate angiogenesis in the ovaries and omental metastases as a prognostic indicator in patients with epithelial ovarian carcinoma. STUDY DESIGN: Ovarian specimens of 42 consecutive patients with primary epithelial ovarian carcinoma (stages I to IV) and omental metastases of 19 of these patients with stage IIIB or stage IIIC disease were stained immunohistochemically for factor VII-related antigen. Microvessel counts were tested for correlation with patient age, stage of disease, type of tumor, preoperative serum CA 125 level, tumor size, tumor resectability, patient survival, and omental microvessel counts. Statistical analysis included parametric (factorial analysis of variance) and nonparametric (Mann-Whitney and Kruskal-Wallis) group comparison tests, parametric (Pearson) and nonparametric (Spearman) correlation tests, and parametric (Cox proportional hazards) and nonparametric (Kaplan-Meier) survival analysis with p < 0.05 considered significant throughout. RESULTS: Microvessel counts of omental metastases in patients with stage IIIB or stage IIIC ovarian carcinoma were significantly correlated with preoperative serum CA 125 level (p = 0.028) and patient survival (p = 0.019). Microvessel counts of the ovaries examined were not correlated with patient age, stage of disease, type of tumor, preoperative serum CA 125 level, tumor size, tumor resectability, patient survival, or microvessel count of the corresponding omental metastases. CONCLUSION: Microvessel count of omental metastases is an independent prognostic indicator of survival in patients with advanced epithelial ovarian carcinoma and correlates with preoperative serum CA 125 level.